Managing Diabetes: Incentives and 'Coaches' Improve Health, Lower Costs

A diabetes management program helped employers reduce costs by $1,467 per participant

By Stephen Miller May 15, 2009

The not-for-profit Midwest Business Group on Health (MBGH), an association of public and private employers, announced the first-year results of Taking Control of Your Health, an employer-based diabetes management program, at its annual conference held May 7-8, 2009, in Chicago.

The results indicate high satisfaction, cost savings and improvement in key clinical indicators used to measure how well patients are managing their diabetes. In one year, the employers’ return on investment of actual savings per participant was $1,467 — or $126,162 for all 86 participants compared to the projected costs for diabetics not in the program. Average total health care costs paid by participants declined by almost $625.

A Value-Based Approach

Taking Control of Your Health, which had over 200 participating patients during the study period, is open to covered employees, dependents and retirees from employer members of MBGH. The program uses a value-based benefit design strategy with three primary elements:

  1. The employer reduces or waives co-pays for diabetic drugs and supplies.
  2. The patients sign an agreement that commits them to education and face-to-face coaching on diabetes self-management in return for the reduced drug costs.
  3. Pharmacists are trained as diabetes coaches to assist patients on a regular basis. (MBGH partners with the Illinois Pharmacist Association to train pharmacists in patient education, monitoring of clinical conditions and motivation according to guidelines of the American Diabetes Association.)

The objective is to enable patients to reach individual goals for:

Medication compliance.


Weight management.

The first-year results looked at 86 participants who received benefits from four Chicago-area based employers: the City of Naperville, the not-for-profit Jewish Federation of Metropolitan Chicago, Hospira (a global pharmaceutical delivery company) and Pactiv Corp. (a foodservice/food packaging firm).

“Not only did we realize an improvement in clinical indicators and cost savings, but we were pleased to see a high level of satisfaction from our participating employees regarding their overall diabetes care,” Judith Hearn, health and welfare manager for Pactiv Corp., told the conference. “This program has enabled us to provide our employees that have diabetes with additional tools and support to help them actively manage their condition as well as incentives for them to take action.”

“Through this program, we’ve demonstrated the value of collaboration between patients, physicians and pharmacists to improve care and reduce costs,” said Larry Boress, MBGH president and CEO. “A key barrier to improvement in chronic disease is the lack of medication compliance. Rarely does someone just have diabetes—they often have other conditions, including hypertension, cardiac problems and depression, requiring them to take an average of five to 13 medications. Having a pharmacist coach helps patients understand the importance of taking their drugs and managing their health.”

“The results of this program show the effectiveness of having pharmacists establish relationships with program participants to serve as diabetes coaches,” added Starlin Haydon-Greatting, clinical project coordinator at the Illinois Pharmacists Association. “In addition to the physician community, the involvement of pharmacists serving as coach, clinician and cheerleader for patients has been invaluable in helping patients manage their diabetes.”

An Expanding Program

Taking Control of Your Health is an ongoing program coordinated by MBGH in cooperation with the Illinois Pharmacists Association. The program was endorsed by the Illinois Academy of Family Physicians and the Institute of Medicine of Chicago. It is part of The Diabetes Ten City Challenge, a national value-based benefit design program to improve the health and reduce the long-term health care costs of diabetic workers.

MBGH announced it is expanding the program to all interested employers during 2009, and it plans to extend the program's scope to include other critical health care needs such as asthma, cardiovascular conditions and depression. More information is available on the MBGH's Taking Control of Your Health web page.

Stephen Miller, CEBS, is an online editor/manager for SHRM. Follow him on Twitter @SHRMsmiller.


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